Background Several small studies have reported a lower responserate to interferon alfa among black patients with chronic hepatitisC infection than among white patients. The increased prevalenceof infection with hepatitis C virus (HCV) genotype 1, whichhas a lower response rate than other genotypes, has been suggestedas the cause.
Methods We treated 100 black patients and 100 non-Hispanic whitepatients with chronic hepatitis C with peginterferon alfa-2band ribavirin for 48 weeks. Enrollment was controlled so thatthe two groups had similar proportions of patients with genotype1 infection. The primary end point was a sustained virologicresponse, which was defined as a negative test for serum HCVRNA six months after the completion of therapy.
Results In both cohorts, 98 percent of patients had genotype1 infection. The rate of sustained virologic response was higheramong non-Hispanic white patients than among black patients(52 percent vs.19 percent, P<0.001). The black patients alsohad significantly lower rates of virologic response at 12 weeksand at the end of treatment. Multivariable analyses examiningsociodemographic and clinical characteristics found that blackrace was the only variable significantly associated with thedifference in response rate.
Conclusions Black patients with chronic hepatitis C have a lowerrate of response to treatment with peginterferon alfa-2b andribavirin than non-Hispanic white patients, a difference thatis not explained by differences in the viral genotype.
Source Information
From the Division of Gastroenterology (A.J.M., J.D.B., P.G.K.) and the Duke Clinical Research Institute (A.J.M.), Duke University, Durham, N.C.
Address reprint requests to Dr. Muir at Duke University Medical Center, Box 3913, Durham, NC 27710, or at muir0002{at}mc.duke.edu.
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